POS0810 FREQUENCY OF VISUAL MANIFESTATIONS IN GIANT CELL ARTERITIS IN NORFOLK
Authors: S. Mansfield-Smith, M. Al-Hashimi, C. Jones, C. Mukhtyar
Journal: Annals of the Rheumatic Diseases (2022)

Background The ophthalmic features of giant cell arteritis (GCA) involve a spectrum of severity from transient symptoms to bilateral visual loss from anterior ischaemic optic neuropathy or less commonly central retinal or cilioretinal artery occlusion. Reported ocular involvement varies between 10-70%. 1,2 . At the Norfolk and Norwich University Hospital an interdisciplinary fast track service is provided for potential GCA patients. This report aims provides a complete picture of the frequency and nature of ocular involvement in GCA. Objectives 350 records of consecutive patients diagnosed objectively with GCA based on biopsy or imaging were reviewed. In our centre, the hospital pathway mandates all suspected GCA cases to have a formal ophthalmology assessment including visual acuity, pupil exam and full-dilated fundus assessment. Systemic and Ophthalmic symptoms and signs were recorded. Methods From January 2012 to September 2021, 350 individuals were diagnosed with GCA by biopsy, ultrasonography or positron emission tomography. The mean age was 74 ± 7.7 years. 235 (67%) of patients were females. 101 (29%) presenting with GCA had visual symptoms and/or signs. 42 of them had mono-ocular and 5 had binocular loss of vision. A summary of the key visual symptoms and signs are shown in Table 1. Only 6 patients with visual symptoms did not have any symptoms commonly associated with GCA. Table 1. Visual Symptoms and Signs (N=350 patients) Visual Symptoms 101 Blurred Vision 36 Loss of vision 47 Double Vision 27 Ocular Signs Right CRAO 1 1 Left CRAO 1 10 Right AION 2 19 Left AION 2 23 Right extraocular muscle weakness 6 Left extraocular muscle weakness 4 1 Central retinal artery occlusion 2 Anterior ischaemic optic neuropathy Results From January 2012 to September 2021, 350 individuals were diagnosed with GCA by biopsy, ultrasonography or positron emission tomography. The mean age was 74 ± 7.7 years. 235 (67%) of patients were females. 101 (29%) presenting with GCA had visual symptoms and/or signs. 42 of them had mono-ocular and 5 had binocular loss of vision. A summary of the key visual symptoms and signs are shown in Table 1. Only 6 patients with visual symptoms did not have any extra-ocular symptoms commonly associated with GCA. Conclusion We report the frequency of visual involvement in one of the largest cohorts of individuals with GCA. 29% have ocular symptoms. Partial or total field loss occurred in 13% of cases. 2% of patients presented with visual manifestations as the only feature of GCA. Rarely, permanent visual loss may occur without any other manifestation of GCA. References [1]Ivana Vodopivec, Joseph F Rizzo, III, Ophthalmic manifestations of giant cell arteritis, Rheumatology , Volume 57, Issue suppl_2, February 2018, Pages ii63–ii72. [2]Saleh M, Turesson C, Englund M, Merkel PA, Mohammad AJ. Visual Complications in Patients with Biopsy-proven Giant Cell Arteritis: A Population-based Study. J Rheumatol . 2016;43(8):1559-1565. Disclosure of Interests None declared